Senior Care Records.

Facility Evaluation Report

Apk Serene, Kern, Oceanside01/26/2023Licence 374602666

Capacity5
Census3
Date signed01/26/2023 05:22:32 PM
The inspector’s account

Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced Case Management visit. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Lead Caregiver Princess Payanga. LPA then met and discussed the purpose of the visit with Administrator Joseph Luevano, who arrived later during the visit.

Today’s visit was in response to the death of Client #1 (C1 – See LIC811 Confidential Names List for identification of C1), which licensee self-reported to the San Diego CCLD Regional Office. Licensee reported during the early morning of 01-22-2023, staff observed C1 was in bed, but pale and unresponsive. Staff called 911, but paramedics pronounced C1's death at the facility.

LPA briefly toured the facility and attempted to perform a welfare check on the remaining 3 clients in care. However, during LPA's visit, all 3 clients were attending off-site day programs. LPA interviewed staff and obtained copies of pertinent facility records. No deficiencies were identified or cited on this date.

An exit interview was conducted with Luevano, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 01/16) were provided.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction